Brown Ch 14 Flashcards
an approach to practice that attaches importance to the individual’s values and preferences and respects the expertise that the person brings to the situation in the form of lived experience
Clients-centered practice
When therapists and clients approach clinical decisions jointly, better outcomes are possible, why?
because both parties have the opportunity to bring their respective expertise to the situation to make an informed choice
The practice of shared decision-making promotes..
equality and mutuality between therapist and client, but because therapists are in a position of power, they must create an environment in which collaboration can occur to the extent desired by the patient
creates a common ground for the confluence of evidence-based practice and client-centered practice
Shared decision-making
Shared decision-making necessitates communication that follows a specific course:
Listen: the therapist listens to the client’s values, preferences, and particular life circumstances.
Speak: in the context of the information provided by the client, the therapist presents options and explains the pros and cons of each.
Listen again: the therapist then listens to the client weigh the options.
the degree to which individuals have the ability to find, understand and use in-formation and services to inform health-related decisions and actions for themselves and others
Health literacy
Four components of the shared decision-making process:
The interaction involves at least two people, including the therapist and client.
Both individuals take steps to participate in decision-making.
Both individuals participate in consensus building.
An agreement is reached on the treatment to implement.
A space that is free from distraction and allows for private discussion will facilitate greater connection between therapist and client.
Engaging the client in the process
Ask the client to talk about their values and preferences, desired outcomes, any activities that they would like to resume, financial resources, social supports, and living arrangements.
Consensus building
A space that is free from distraction and allows for private discussion will facilitate greater connection between therapist and client.
Open-ended questions that promote discussion and active listening with paraphrasing encourage openness from the client.
The therapist’s nonverbal cues, such as an open and forward-leaning posture, eye contact, and head nods, can indicate warmth and attentiveness.
Engaging the client in the process
Shared decision-making results in an agreement about the direction that intervention will take.
This does not necessarily mean that both parties conclude that the intervention chosen is the best one or that both parties are equally involved in the decisions.
Agreement
Decision aids increase
client involvement, improve knowledge, create a more realistic perception of outcomes, and reduce discretionary surgery
provide information to the client to support the decision-making process in the form of written materials, videos, interactive Internet presentations, etc
Decison aids
Decision aids generally provide:
Explanation of the condition and how interventions can work to target specific aspects of it
Identification of the decision that needs to be made, including the different interventions that are available and the option of no intervention
Options and potential outcomes based on scientific evidence
Questions to help clients clarify their values
Mayo Clinic
The Ottawa Hospital Research Institiue
CommonGround Software
Resources for shared decision-making
